BRAVO
Received May 5, 2026 · Event occurred Apr 10, 2026
Report 9710107-2026-00186 · MDR key 25081609
Device
Generic name
Electrode, Ph, Stomach
Manufacturer
Given Imaging Ltd., YoqneamModel number
FGS-0635Catalog number
FGS-0635
Lot number
67839F
Product problems
- Positioning Failure
Patient
67 YR · Female
- Foreign Body In Patient
Narrative
Description of Event or Problem
IT WAS REPORTED THAT THE CAPSULE FAILED TO ATTACH TO THE PATIENT¿S ESOPHAGUS. THE CAPSULE WAS NOT RETRIEVED. THEY PLACED ANOTHER CAPSULE ON THE SAME PROCEDURE AND ATTACHED SUCCESSFULLY. THERE WAS NO PATIENT AND USER HARM. NO LUBRICANT WAS USED TO FACILITATE THE PLACEMENT OF THE CAPSULE.
Additional Manufacturer Narrative
H3 EVALUATION SUMMARY: MEDTRONIC CONDUCTED AN INVESTIGATION BASED UPON ALL INFORMATION RECEIVED. THE CAPSULE WAS NOT RETURNED, BUT THE DELIVERY SYSTEM WAS AVAILABLE FOR EVALUATION. VISUAL INSPECTION OF THE DELIVERY DEVICE FOUND NO NOTABLE CONDITIONS. A COMPREHENSIVE EXAMINATION COULD NOT BE PERFORMED, BECAUSE THE RETURNED SAMPLE WAS NOT RECEIVED IN A STATE THAT ALLOWED FULL FUNCTIONAL OR VISUAL ASSESSMENT. IT WAS REPORTED THAT THE BRAVO CAPSULE FAILED TO ATTACH TO THE PATIENT'S ESOPHAGUS. THE REPORTED ISSUE COULD NOT BE CONFIRMED. THE MOST LIKELY CAUSE COULD NOT BE ESTABLISHED FROM THE INFORMATION AVAILABLE. THE MANUFACTURING RECORDS FOR EACH DEVICE ARE THOROUGHLY REVIEWED PRIOR TO RELEASE TO ENSURE THAT IT MEETS ALL MEDTRONIC QUALITY SPECIFICATIONS. MEDTRONIC SUBMITS THIS REPORT TO COMPLY WITH FDA REGULATIONS 21 CFR PARTS 4 AND 803. MEDTRONIC HAS MADE REASONABLE EFFORTS TO PROVIDE AS MUCH RELEVANT INFORMATION AS IS AVAILABLE TO THE COMPANY AS OF THE SUBMISSION DATE OF THIS REPORT. THIS REPORT DOES NOT CONSTITUTE AN ADMISSION OR A CONCLUSION BY FDA, MEDTRONIC, OR ITS EMPLOYEES THAT THE DEVICE, MEDTRONIC, OR ITS EMPLOYEE CAUSED OR CONTRIBUTED TO THE EVENT DESCRIBED IN THE REPORT. ANY REQUIRED FIELDS THAT ARE UNPOPULATED ARE BLANK BECAUSE THE INFORMATION IS CURRENTLY UNKNOWN OR UNAVAILABLE. MEDTRONIC WILL SUBMIT A SUPPLEMENTAL REPORT IF ADDITIONAL RELEVANT INFORMATION BECOMES KNOWN.